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Laren: Return to Sport from Hip Surgery

One of the best parts of my job is seeing the progress of an athlete who has gone through an injury and is dedicated to returning to their sport. I have been involved in the rehab and return to sport process of ACL reconstructions, shoulder reconstructions and tendinopathy and fractured wrists. Most notably however is a cricket athlete of mine, Laren, who after years of repetitive loading through his hip from fast bowling developed a CAM lesion and labarum tear in his hip. After managing the injury during his last season of cricket he went in for surgery during the off season. I’d like to give you all a little insight into the process of getting him back playing.

Stage 1: Restore proprioception and muscle activation.

In the very early stages his rehab the main goal was to restore activation of the smaller glute muscles with some range of motion improvements. Due to the nature of his surgery we had to tread carefully with how much we mobilised and loaded the joint to not aggravate a surgical fracture created to aid recovery. Therefore, majority of the exercises were body weight and were proprioceptive based, ie: supported SL balancing progressing to unsupported SL balancing with eyes closed.

Stage 2: Restore range of motion and neuromuscular firing patterns.

The aim for this phase was to improve firing patterns and mobility of compound movements. I began to add in body weight squats to a high marker with the progression to first increase the range before adding excessive load. Along with this we also included kettlebell Romanian deadlifts (RDL), mini-band hip thrusts and low box step ups as accessory movements to further improve strength and to start loading the hip. The assault bike became his best friend during this time as it is a great way to put the hip through motion in a low load and not impact setting.

Due to compensatory movement patterns and tight muscles Laren developed a mild patellar tendinopathy which was managed through isometric and tempo loading and soft tissue treatments.

Stage 3: Improve muscle mass and strength and return to running.

Laren then completed a good 8 – 10 weeks of hypertrophy / strength biased programming to improve muscle size and strength to ensure the muscles and tendons were strong enough to handle higher loads prior to a strength bias phase. During this phase we also worked on basic jumping and landing mechanics drills to start providing impact loading. We saw further mobility improvements during this phase where Laren can now squat lower than pre – surgery! Laren had been given the clear by his physio for any movement restrictions and he began the return to running phase.

Stage 4: Return to sport.

Now the foundation had been laid, it was time to reintroduce some higher level movements such as weightlifting, higher level jumping/plyometrics and other power exercises (loaded and unloaded) in combination with continuing to improve strength in the fundamental movements.

Laren is able to now bowl during training and has now played his first match, although not ready for match bowling he is able to field and bat with no issues. He has been very consistent with his rehab which has shown in his recovery. Although initially the process is monotonous, it is essential to lay foundations for later training to allow for return to sport safely and effectively.

If you would like any further information on returning to sport after an injury, feel free to contact me at mitch@gw-performance.com.